There is a critical and growing need for emergency physicians and emergency medicine resources worldwide. To meet this need, physicians must be trained to deliver time-sensitive interventions and life-saving emergency care. Currently, there is no internationally recognized, standard curriculum that defines the basic minimum standards for emergency medicine education. To address this lack, the International Federation for Emergency Medicine (IFEM) convened a committee of international physicians, health professionals, and other experts in emergency medicine and international emergency medicine development to outline a curriculum for foundation training of medical students in emergency medicine. This curriculum document represents the consensus of recommendations by this committee. The curriculum is designed with a focus on the basic minimum emergency medicine educational content that any medical school should be delivering to its students during their undergraduate years of training. It is not designed to be prescriptive, but to assist educators and emergency medicine leadership in advancing physician education in basic emergency medicine content. The content would be relevant, not just for communities with mature emergency medicine systems, but also for developing nations or for nations seeking to expand emergency medicine within current educational structures. We anticipate that there will be wide variability in how this curriculum is implemented and taught, reflecting the existing educational milieu, the resources available, and the goals of the institutions’ educational leadership.

Vision: To create an international model curriculum for medical student foundation training in emergency medicine.

Rationale: There is critical, overwhelming, and growing need for emergency physicians and other administrative, professional, clinical, and academic emergency medicine resources worldwide. Currently, there exist a small number of national curricula for emergency medicine, but there is no standard, widely recognized international curriculum for medical students.

Demand: Currently worldwide, there are roughly 50+ countries involved in the processes of emergency medicine development. Internationally, a consensus is building regarding the demand for an international minimum basic standard for emergency medicine curriculum content.

Goal: To establish, develop, and maintain an international curriculum for medical student foundation training in emergency medicine. The curriculum should be compiled by an international consortium of physicians, health professionals, and other experts in emergency medicine and international emergency medicine development. Further it should be approved, amended, and maintained by an international collection of such experts.

Endpoint: To further train and educate physicians, medical professionals, and other experts in emergency medicine in order to provide the best quality emergency care in the multiple and growing number of nations where it is currently practiced and to further establish emergency medicine as a medical profession worldwide.

Society has a right to expect that at the completion of their undergraduate medical school training all physicians possess the basic knowledge of emergency care and the skills to manage common acute problems.

Emergency medicine is a core medical discipline and should be a required portion of the curriculum for every medical school, and every medical student, in the world.

Every physician, and graduating medical student, should be able to provide care in an emergency situation without any faults or lack of confidence and should be independent of the site of the emergency.

Every physician, and medical student, should be able to manage clinical decision-making under pressure of time when it is essential to save lives.

Competence in basic emergency medicine should be an outcome measure for all medical students and represent a criterion required for conferral of the degree.

This curriculum establishes an international consensus on the core content of undergraduate level emergency medicine training with the goal of elevating the quality of acute care worldwide through an expansion of basic emergency medicine education. This curriculum further reflects the importance of emergency medicine as a medical profession worldwide. The document is organized sequentially, as a framework rather than a comprehensive plan. Educators using this curriculum should make use of the framework to develop educational programs that are contextualized and specifically meet local educational requirements. This model allows easy adaptation of any of the features and provides an example of an expanded 4-year curriculum for a single learning objective.

The clinical settings and environmental context for medical education varies widely throughout the world. To attain minimum basic competency in emergency medicine core learning objectives, medical students must be given a variety of opportunities for professional development. These opportunities should be longitudinal in nature, begin early in the preclinical years, and extend into clinical contexts that allow focus on acute and emergency conditions. The following basic guidelines should structure the educational process of achieving core competencies in minimum emergency medicine knowledge and skills.

During undergraduate and early training every medical student should:

Acquire a fundamental knowledge of basic sciences as applied to emergency medicine and have the ability to assess and immediately treat common emergencies.

These learning objectives are designed to allow easy modification to the local needs and are written so that objective measures of performance and competency can be designed to measure attainment of the learning objective.

The student should

1.

Acquire basic life support skills, including the diagnosis and treatment of shock and the related basic procedural skills, and demonstrate the basic application of these principles in real or simulated patient care scenarios.

2.

Demonstrate the capacity to differentiate and treat common acute problems.

3.

Provide a comprehensive assessment of the undifferentiated patient.

4.

Demonstrate proficiency in basic life support skills and cardiopulmonary resuscitation.

5.

Recognize and initiate first aid for airway obstruction.

6.

Recognize and be prepared to intervene for all causes of shock in any age group.

7.

Be able to provide rapid stabilization with intravenous access and fluid/blood administration.

8.

Understand the principles of cerebral resuscitation in brain illness and injury.

9.

Demonstrate proficiency in the use of an automatic external defibrillator (AED).

10.

Understand the principles of wound care.

11.

Demonstrate basic wound care techniques.

12.

Understand the principles of trauma management.

13.

Demonstrate basic trauma management skills, such as initial assessment using the ABC approach and full spine immobilization.

14.

Demonstrate mastery of basic procedural skills, such as airway management and venous access.

15.

Recognize life-threatening illness or injury and apply basic principles of stabilization to the early management of these entities.

16.

Demonstrate the capacity to prioritize attention to those patients with more urgent conditions.

17.

Describe the importance of the emergency department as a key link between the general population and the health care system.

18.

Understand the role of the situations that are unique to emergency medicine: acute critical illness, intoxicated patients, media, out-of-hospital personnel, death notification for sudden unexpected death, disaster, language barriers, environmental illness/injury, injury prevention, assessment of complex and undifferentiated patients, and ability to synthesize multiple and often incomplete sources of information to develop a management plan.

To assist educators in crafting a curriculum that fits local needs, we have provided an example of a 4-year plan for a single learning objective. Educators may use this as a guide to construct individual-, national-, and institution-specific models for content delivery. This method is not intended to be prescriptive, but to provide a simple model for tailoring content to the unique educational models that exist throughout the world.